Lists of hospitals with patient death rates exceeding national avg have been created. The data is adjusted for ages of patients (i.e hospitals catering to older patients are expected to have higher death rates so the data is adjusted accordingly)

The hospitals do not want the rank on these lists to be a measure of quality of hospital care. Each option except one gives a logical reason for hospitals' opposition.


(A) Rank order might indicate insignificant differences, rather than large differences, in numbers of patient deaths.

What if differences are minor such as 10.056 per 1000 and 10.1 per 1000 but they differ by 100 in their rank? The difference may be considered insignificant in number terms but in rank terms it makes one hospital look far worse than the other.

(B) Hospitals that keep patients longer are likely to have higher death rates than those that discharge patients earlier but do not record deaths of patients at home after discharge.

Certainly a valid point. Hospitals who give care longer to the patient will have higher death rates than hospitals who send patients away quickly and then not record their death. Hence death rate may not be good measure of the care the hospital provides.

(C) Patients who are very old on admission to a hospital are less likely than younger patients to survive the same types of illnesses or surgical procedures.

The data has already been adjusted for age differences. Hence the hospitals cannot complain about this and this is not a logical point.
Hence this is the answer.

(D) Some hospitals serve a larger proportion of low-income patients, who tend to be more seriously ill when admitted to a hospital.

A valid point again. If patients coming in are more seriously ill, the death rates are expected to be higher so the hospital should not be penalised for that.

(E) For-profit hospitals sometimes do not provide intensive-care units and other expensive services for very sick patients but refer or transfer such patients to other hospitals.

Some hospitals do not provide services to very sick patients but refer them to other (perhaps specialised) hospitals. The death rate in these hospitals will be lower than the death rate in other hospitals. If they treat only the easily treatable cases, they are bound to have better standing in death rates. Hence (E) is a valid concern against the lists too.

Answer (C)
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I would say C.

B,D & E are in effect say that some hospital take more risk or try to handle more complicated illnesses.

A might be right, but it actually may be a ground to object ranking as a way of comparing quality of hospital services. Not quite sure about A

But I will stay with C. (assuming that older people evenly distributed along all hospitals - C does not give ground to object ranking)

IMO, C is the answer because the argument that different ages bias the data is made moot by the fact that age differentials were somehow "adjusted" or normalized.

I will go for C.
Because the argument says "The data have been adjusted to allow for differences in the ages of patients"
Now when age differences have already been taken into account, what logical ground hospitals have to object ranking based on C.
thanks, Vicks

(A) Rank order might indicate insignificant differences, rather than large differences, in numbers of patient deaths.I don't really think this providea a "good logical ground" but C is the "better" answer
(B) Hospitals that keep patients longer are likely to have higher death rates than those that discharge patients earlier but do not record deaths of patients at home after discharge.Hospitals can say they are better than their rank because they chose to keep the really sick
(C) Patients who are very old on admission to a hospital are less likely than younger patients to survive the same types of illnesses or surgical procedures.This is the only one that clearly doesn't refute the list and rank, as the rank has already been adjusted for age. Best answer.
(D) Some hospitals serve a larger proportion of low-income patients, who tend to be more seriously ill when admitted to a hospital.The hospital could still provide good care, but just get a lot of poor patients
(E) For-profit hospitals sometimes do not provide intensive-care units and other expensive services for very sick patients but refer or transfer such patients to other hospitals.The hospitals with IC units will get a lot more really sick people, but that doesn't mean the for-profit hospitals are better

@GMATNinja,@GMATNinjaTwo, gmat1393, nightblade354

I understand option C. But what does option E mean and why is it wrong ??

mallya12

Please refer the explanation in below link

https://gmatclub.com/forum/lists-of-hos ... l#p2248268

What does it mean when option E tells FOR-profit hospitals don't provide IC units and other expensive services??? If they have specialised system why are they referring to other hospitals??

Healthcare is a basic civic amenity and hence, there may be Govt aided not-for-profit hospitals.
For-profit hospitals would be those which are in the industry to earn money and they may not keep very expensive facilities, say diagnostic machines, because of cost factor. So they may refer critical patients needing these expensive machines to Govt aided hospitals or specialised hospitals which have high tech facilities.
Then death rates of these for-profit hospitals may not be comparable to those of Govt aided or specialised facilities hospitals.
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I think the hardest part about this problem is not understanding the stem but understanding the actual question

'Each of the following, if true, provides a good logical ground for hospitals to object to interpreting rank on these lists as one of the indices of the quality of hospital care EXCEPT:'

Would never have got what they wanted from me here before I've seen an explanation.
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A.) Provides a reason for objection.

B.) Provides a drawback of the factor

C.) Correct - Data also includes the differences in the age of the patients.

D.) Provides a drawback of the factor.

E.) Provides a drawback of the factor.

The devil is in this bold part of the argument.

Lists of hospitals have been compiled showing which hospitals have patient death rates exceeding the national average. The data have been adjusted to allow for differences in the ages of patients.

this is the first CR question where I couldn't understand what question stem asked me to do.



I only understood the question after I saw an explanation. How to deal with this?

Hi HorseGiggles, first of all - amazing name! Kudos on that!

This is a 700 level "Except" type CR question. Such question stem in general asks to choose an option which will not strengthen/weaken/evaluate/resolve paradox, but the other four options will.

Except-type CR Questions - Just solve a few questions and you will get the hang of it.
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I'm not sure if the difficulty stems from the convoluted double-negative in the question ("to object... EXCEPT"), or if it stems from the use of "indices", in one of its uncommon meanings. "Indices" is the plural of "index", which is usually a section of a book, but can also mean "indicator", and that's the meaning intended here. You're not likely to ever see that word again in a GMAT question, so if that was the issue, it's nothing to be concerned about.

But in general, in an EXCEPT question, the question will usually be asking something like "every answer choice strengthens the argument EXCEPT" or "every answer choice weakens the argument EXCEPT" or "every answer choice is an assumption EXCEPT". So if a question said:

"Each of the following {something incomprehensible} EXCEPT"

then you will always find four answers that have the same overall effect on the argument, and one that does not. So even if you didn't understand the wording of the question, if you noticed four answer choices strengthen the argument, and one is either irrelevant or weakens it, then that one answer will be the right answer.
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Thank you for the reply, and I am happy that you liked the name
What I meant was I could not understand the wordings of the question stem or how it was structured, I have solved Except type CR question and I am familiar with the type. none the less thank you for replying again!

(A) Rank order might indicate insignificant differences, rather than large differences, in numbers of patient deaths.
This can be possible reason to elemiate the ranking system since ther emight not a be a significant difference however since the ranking is only taking one parameter which is subjectiv/e and cannot portray the full picture-hence out

(B) Hospitals that keep patients longer are likely to have higher death rates than those that discharge patients earlier but do not record deaths of patients at home after discharge.
This also weakens since it might not be refle/ctive of their medical care those who were kept for a death could have been adjused with the best medical ccare and in spite of this they might not been able to save the patient whereas in the latter case inorder to ring the system they might have discharge the patient to climb the ranking system even thay/ might not have the best med/ical care -hence out

(C) Patients who are very old on admission to a hospital are less likely than younger patients to survive the same types of illnesses or surgical procedures.
The demographic in question whose distribution is subjective speculation let us assume an even distribution this means they will be admitted to hospitals in evey geographic and their survival likelihood depends on the medical care of the hospitals only if every hospital puts in their best care can they make them survive since every hospital has to face the same dilemma we can assume this is a valid parameter - let us hang on to it

(D) Some hospitals serve a larger proportion of low-income patients, who tend to be more seriously ill when admitted to a hospital.
This is another reason since dispropotion and unequal probability parameters affect the ranking system we have a valid to provide objection - hence out

(E) For-profit hospitals sometimes do not provide intensive-care units and other expensive services for very sick patients but refer or transfer such patients to other hospitals.
This in a simialr reasoning to B is utilising the loop holes in the ranking system to bias the ranking in order to get foothold since they are not emplyoing their best medical assets in saving the patient
Hence IMO C

(C) is it. Premise says that the data is ALREADY adjusted for patients' ages.